OTITIS MEDIA WITH EFFUSION: HUMAN STUDIES

渗出液的中耳炎：人类研究

• 批准号: 3393842
• 负责人: David J. Lim
• 金额: $ 50.06万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1977
• 资助国家: 美国
• 起止时间: 1977-09-01 至 1992-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3393842
• 关键词: antibiotics; bacterial cytopathogenic effect; bactericidal immunity; cholesteatoma; complement; disease /disorder model; disease /disorder prevention /control; ear disorder diagnosis; electron microscopy; histochemistry /cytochemistry; human tissue; immune tolerance /unresponsiveness; immunochemistry; immunoglobulins; immunopathology diagnosis; lysozyme; microorganism classification; microorganism culture; microorganism immunology; model design /development; otitis media; phagocytosis; preschool child (1-5); protease inhibitor; respiratory infections; virus cytopathogenic effect

Otitis media with effusion (OME), or serous otitis media, is a common condition in children and frequently leads to a moderate deafness at a critical age of development. The long-term objectives of this study are: 1) to determine the pathogenesis of OME in humans, 2) to develop suitable animal models for OME, and 3) to develop a scientific rationale for diagnostic, preventive and management strategies for OME. The specific objectives are to define the roles of tubal dysfunction, antecedent acute bacterial otitis media, respiratory virus, bacterial (or viral) antigens, bacteria- (or virus-) host interaction, immune protection, immune injury, and antibiotics in the pathogenesis of OME, using microbiological, immunochemical, histopathological and immunocytochemical techniques in human OME patients and in animal experimental models. The major hypotheses to test are: 1. Initial infection may be modified by the local production of bacteriostatic substances (immunoglobulins and lysozyme), impaired phagocytic function, and/or inadequate antibiotic treatment, leading to OME. 2. After initial infection, dead bacteria or bacterial (or viral) antigens may remain in the middle ear due to poor tubal function, which can elicit immune injury or nonspecific activation of mediators of inflammation, leading to OME. Such substances include endotoxin and peptidoglycan. 3. Viral infection (upper respiratory tract) may predispose the middle ear to bacterial infection due to suppression of immune responses and/or impairment of local clearance mechanisms. 4. Early antibiotic treatment of an initial ear infection prevents the development of adequate immunity of the ear, particularly in the young age group (under two years of age) whose immune systems are being developed, and subsequent infection results in OME due to the incomplete development of immunity in the middle ear.

渗出性中耳炎 (OME) 或浆液性中耳炎是一种常见的 儿童的情况，经常导致中度耳聋 发育的关键年龄。 本研究的长期目标是： 1) 确定 人类OME的发病机制，2）开发合适的动物模型 OME，以及 3) 为诊断、预防制定科学依据 OME 的管理策略。 具体目标是定义 输卵管功能障碍、既往急性细菌性中耳炎的作用， 呼吸道病毒、细菌（或病毒）抗原、细菌-（或病毒-） 宿主相互作用、免疫保护、免疫损伤和抗生素 OME 的发病机制，利用微生物学、免疫化学、 人类 OME 患者的组织病理学和免疫细胞化学技术 以及在动物实验模型中。 要检验的主要假设是： 1. 初始感染可能会因当地生产而改变 抑菌物质（免疫球蛋白和溶菌酶），受损 吞噬功能和/或抗生素治疗不充分，导致 OME。 2.初次感染后，细菌或细菌（或病毒）抗原死亡 由于输卵管功能不良，可能会留在中耳，从而引起 免疫损伤或炎症介质的非特异性激活， 通向 OME。 此类物质包括内毒素和肽聚糖。 3.病毒感染（上呼吸道）可能易患中耳病 由于免疫反应抑制而导致细菌感染和/或 当地清除机制受损。 4. 早期耳部感染的早期抗生素治疗可以预防 耳朵有足够的免疫力，特别是在年轻时 免疫系统正在发育的群体（两岁以下）， 由于发育不完全，随后的感染导致 OME 中耳的免疫力。